Emotions in Medical Decision Making in Older Adults

老年人医疗决策中的情绪

• 批准号: 6838109
• 负责人: WILLIAM DALE
• 金额: $ 16.22万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6838109
• 关键词: anxiety; behavioral /social science research tag; biopsy; choice; clinical research; cost effectiveness; decision making; health surveys; human old age (65+); human subject; interview; longitudinal human study; male; neoplasm /cancer diagnosis; neoplasm /cancer therapy; patient oriented research; prostate neoplasms

DESCRIPTION (provided by applicant): Research on medical decision-making makes use of insights from economics and statistics to build quantitative models of clinical decisions. These models rely on assumptions about the use of information by decision-makers, including the core assumption that people process information in a narrowly logical manner. Recently, the psychology of decision-makers, including their emotional states, is being incorporated into these models to augment the role of cognition. Research on older adults differs importantly from other populations in a number of ways that may impact medical decision-making, especially the role of emotions. Pursuing work begun with his dissertation, William Dale, MD, PhD, will enhance his interdisciplinary training in geriatrics and public policy by focusing on a deeper understanding of emotions in medical decision-making in older adults. This research agenda initially utilizes the clinical model of prostate cancer, a widely prevalent disease in older men, and one in which the role of the emotion of anxiety may influence decision-making. Although no consensus exists on the "right" clinical pathway for detecting and treating prostate cancer, there is wide agreement that patient preferences are vital for making choices. Initial investigations indicate the inclusion of anxiety in utility assessments for men with localized prostate cancer dramatically affect the cost-effectiveness ratios for treatments. Further research to assess the contribution of anxiety to utility assessments for these men is on-going. This study serves as a specific core example of the overall career goal of understanding the role of emotions in medical decision-making in older adults. Older adults care occurs in a complicated socio-medico-psychological context that demands sensitivity to the importance of issues such as functional impairments, multiple co-morbidities, polypharmacy, and care-giver burden. As a geriatrician, Dr. Dale is sensitive of including these concerns in pursuing his research. Enhancing his broad-based training in public policy studies and geriatrics with a targeted, in-depth understanding of psychology and medical decision-making under the expert guidance of his mentors, Dr. Dale will build the necessary expertise for a career researching the role of emotions in medical decisions for older adults.

描述（由申请人提供）：医疗决策研究利用经济学和统计学的见解来建立临床决策的定量模型。这些模型依赖于决策者使用信息的假设，包括人们以狭隘逻辑方式处理信息的核心假设。最近，决策者的心理，包括他们的情绪状态，正在被纳入这些模型中，以增强认知的作用。针对老年人的研究在许多方面与其他人群存在显着差异，这些方面可能会影响医疗决策，尤其是情绪的作用。 William Dale 医学博士、哲学博士将从他的论文开始开展工作，他将重点关注对老年人医疗决策中的情绪的更深入理解，从而加强他在老年病学和公共政策方面的跨学科培训。该研究议程最初利用前列腺癌的临床模型，前列腺癌是老年男性中广泛流行的疾病，其中焦虑情绪的作用可能会影响决策。尽管对于检测和治疗前列腺癌的“正确”临床途径尚未达成共识，但人们普遍认为患者的偏好对于做出选择至关重要。初步调查表明，将焦虑纳入对局限性前列腺癌男性的效用评估中会极大地影响治疗的成本效益比。评估焦虑对这些男性效用评估的影响的进一步研究正在进行中。这项研究是了解情绪在老年人医疗决策中的作用的总体职业目标的具体核心例子。老年人护理发生在复杂的社会医学心理背景下，需要对功能障碍、多种合并症、多种药物和护理人员负担等问题的重要性保持敏感。作为一名老年病学家，戴尔博士对将这些问题纳入他的研究非常敏感。戴尔博士在导师的专家指导下，通过对心理学和医疗决策有针对性、深入的了解，加强在公共政策研究和老年病学方面的广泛培训，将为研究情绪在老年人医疗决策中的作用的职业生涯奠定必要的专业知识。